Organization
VILLAGE PEDIATRICS AT VICKERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHALINI MALA SHAH MD (PHYSICIAN/OWNER)
(678) 523-8594
Entity
Organization
Contact information
Practice address
7185 COLFAX AVEUNE, SUITE 200, CUMMING, GA 30040
(678) 990-3362
(678) 550-9587
Mailing address
6515 WESLEY HUGHES RD, CUMMING, GA 30040-6526
(678) 523-8594
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
68556
GA
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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